, Bridge Magazine , News
We talk to Sarah White, CEO of Jean Hailes Women’s Health, on all things menopause. Discussing menopause symptoms openly with your family, friends, and health care providers helps to remove stigma and normalise the menopausal transition. We want all women to feel encouraged to seek support from a health professional if they are struggling with menopause symptoms.
What is menopause?
Menopause is officially 12 months after your last period. The time leading up to it is called perimenopause, and that is the time that your hormone levels (oestrogen and progesterone) start changing and causing a variety of often unwelcome symptoms. These can include hot flushes, increased frequency of urinary tract infections, sleep trouble, fatigue, change in body shape, decline in bone density, incontinence and urgency, depression, anxiety, brain fog, and heart problems, to name but a few.
“Everybody's experience is really individual. Menopause is described as a biopsychosocial event. So, there's a biological factor to it. There's a psychological factor to it. There is a social factor to it. Menopause means very different things in different cultures. It marks the end of fertility—in some cultures that's a really terrible thing, and in some cultures, it is celebrated. We have a huge cultural issue with menopause in Australia, because it is associated with gendered ageism. Gendered ageism is where ageing is seen as a problem for women and yet men of the same age are viewed as having somehow reached seniority and wisdom. Menopause in our society can be presented as the angry, volatile, woman flying off the handle, or being past their use-by date—all those sorts of terrible things that go along with gendered ageism. We must reframe how we consider menopause to get past that social construct around it. We are living a good third of our lives after menopause, so it's not the end and nor is it a sign of old age to go through the menopause transition.”
“Like a lot of women’s health issues, menopause wasn't discussed very openly until recent times. However, we still don't talk much about periods and we certainly don't talk about continence problems or sexually transmitted infections. So out of all those things, I think menopause is not quite as intimidating to discuss.”
How does it affect continence?
Changes in hormone levels during perimenopause can uncover underlying issues with your pelvic floor strength and can cause genitourinary syndrome of menopause (GSM), which affects the urinary tract, the vulva and/or vagina. Perimenopause can be the start of continence issues such as leaking urine when you sneeze or cough or having to visit the toilet very frequently and urgently. GSM can also cause painful sex, because the tissues of the vagina get thinner, and it can cause vulva irritation, dryness and itchiness. If you are experiencing these sorts of changes, go and talk to your doctor because there are creams and pessaries that can help with the GSM and, of course, there are treatments for continence problems, such as physiotherapy and continence devices.
“You don't need to be medically qualified to know your own body and know what is normal for you.”
“Part of this year’s Jean Hailes’ Women’s Health Week theme, Your Voice, Your Choice, was being able to advocate for yourself. So, what we're saying to women is know your body, touch your body, look at your body—every single part of it. Know what your bathroom habits are like. Know what things are like when they are "normal”, because the very best thing we can do for our health is to notice when something is not normal. If you don't know what normal looks like, it's hard to know when something changes. We're encouraging women to get to know their body and their bodily rhythms and routines so that they can talk to their doctor when something changes and say, for example, I'm having to go to the toilet more often.”
Are menopause symptoms treatable?
“YES! 50% of people don’t go to their doctor to get help during perimenopause and we want to change that. Menopause is a great time to go in and have a full ‘grease and oil change’—a full medical checkup: your bloods, your bone health, and your cholesterol.
There is a huge range of treatments—from simple lifestyle changes to significant medical interventions like surgery. Depending on the symptoms which affect your life, there are lots of different options available, from medicines in pills, gel, cream, or patches, to physiotherapy, or psychology.”
Advice for people about to enter menopause
"Be prepared, don’t be scared—1 in 4 women won’t experience any symptoms, 1 in 4 experience extreme symptoms, and the rest will experience a range of symptoms in between.”
"It's a tragedy that we are beginning to have this very welcome, open discussion about how menopause affects women, but it is being hijacked by people who want to make money from it. Researching and discussing your experience online is good to normalise symptoms and hear from people with lived experience but be careful of misinformation. Only read information from credible sources. When you read something online, in the mainstream media, or on social media, consider where the information is coming from and what they might be trying to sell you. Think critically about the information you find online and be especially careful of celebrity influencers both in Australia and based overseas, including GPs, always check the information you see online with your healthcare provider.”
“We say, be prepared, but don't be scared, because we know that people who go into menopause feeling worried about how it's going to affect them, tend to have a worse time of it. And that's because if you're focused and worried about hot flushes, then when you have one, you are already in a heightened state of anxiety about having a hot flush. Managing anxiety around what is going to happen can help. Educate yourself and seek help.”
When should I go to my doctor?
"Menopause is a really important time to go and talk to your doctor. Even if you think, oh, it's just menopause—go and talk to your doctor and get a full health check so that those 30-odd years you live post menopause are lived in good health. If you haven’t already, it is also an important time to start looking after your bone health and your heart health. Because after menopause, women are more at risk of cardiovascular issues and then more at risk of bone loss that leads to osteoporosis.”
“And don’t forget, that menopause presents with the same symptoms as other issues that might not be as benign. So hot flushes can be caused by menopause, but they can also be caused by hypothyroidism. Women need to go to talk to their doctor and if the doctor dismisses it and says it's just menopause, well, ask the doctor about what that actually means. You want a good understanding of what particular aspect of perimenopause is causing your symptoms and what the options are to treat it or at least offer some relief.”
VISIT JEAN HAILES
“We encourage women to download the checklist from Jean Hailes and take it to your doctor, marking off the symptoms you're experiencing and how much they're affecting your life. It is a great conversation starter to discuss symptoms and get the treatment, medication, or devices that can help you through the perimenopause with as little discomfort and impact on your day-to-day life as possible.”
For more information about menopause and incontinence click here.